We are the AMA - Alberta Medical Association

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Certainly many of these services are publiclyfunded, but we argued that physicians shouldremain free to exercise traditional practices, tosee patients in their private practices at theirdiscretion and, if necessary, provide patientswith access to AHS services.48. The point was made several times during theinquiry (and not only by the AMA) that anysolutions to prevent improper preferentialaccess within the queue should not becounterproductive in terms of slowing timeto service or paralyzing clinical autonomy.Certainly this would be the effect ofregulatory measures to control pre-queuemovement of the patient within the doctorpatientrelationship. That is the great pointthat supports the exclusion of this part of thecontinuum from the purview of the inquiryas the AMA has argued.49. What kind of preferential access is“improper?” The AMA believes that allaccess to publicly funded AHS servicesis fundamentally “preferential,” if onlybecause of the fact that someone has to getto a service in a facility first! For example,processes to access specialist services thatare within the queue vary widely. Familyphysicians may have stronger workingrelationships with some consultants thanothers. In some facilities, streamlinedreferral-consultation processes mightimprove efficiency such that patients passingthrough them enter the queue more quickly.These things have always been and theycannot ever be wholly eliminated.50. In the AMA’s eyes, the concept of harm isthe lynchpin. Physicians regularly extendprofessional courtesy to other physicians byseeing those physicians’ family members orfriends out of office hours without bumpingany patients in the existing schedule.51. We do not believe this is harmful,because these things do not underminethe fundamental integrity of access andmovement within the queue based onmedical need. The Canada Health Act doesnot guarantee “equal” or even “equitable”access to health care services, but insteadrequires physicians to “facilitate reasonableaccess.” Once the patient arrives in thequeue as defined, movement forward isbased on medical need. Any movementwithin the queue based on any otherfactors would be improper.52. The commissioner released his report onAugust 21 with his conclusions and 12recommendations. He concluded thatthere was no evidence of widespreadimproper practices although some instancesof improper preferential access wereuncovered. The commissioner found noevidence that “anyone had been medicallyharmed as a result.”53. With respect to issues raised by theAMA, the commissioner did not find thatprofessional courtesy was in and of itselfimproper when limited to services provided“by one physician to another physician orto other professional colleagues such asnurses.” He expressed concern, however,about any extension of such courtesiesbeyond that level and said the AMA,with the regulatory bodies and publicrepresentatives, should “closely examinethe practice and ethical implications18
of professional courtesy with a viewto defining its scope and applicationand providing guidelines to health careprofessionals.” While we see practicaldifficulties to this recommendation (as doesthe registrar of the College of Physicians &Surgeons of Alberta), the AMA is willing toparticipate in such a process.54. Other key commentary from the inquiry reportsupported the concept that the best way toeliminate improper preferential access is toeliminate the queue itself. The AMA welcomesthe recommendation that AHS “continue itscurrent efforts to improve access to healthcare overall and to reduce associated waittimes. It should also consider implementinga comprehensive wait time measurementsystem.” We are also pleased that thecommissioner recommended expansion ofwhistleblower protection to include physicianswho are not employees of AHS.Zone Medical Staff Associations55. In accordance with prior RF direction, theAMA implemented measures to support astrong and integrated partnership betweenthe AMA and the zone medical staffassociations (ZMSAs). This has includedproviding channels of communication,Scan to learn moreabout ZMSAs, or visitwww.albertadoctors.org/about/leaders/zmsasrepresentation and advocacy back and tothe AMA through Zonal Advisory Forums(ZAFs). Calgary and Edmonton ZMSAs arefully functioning and hosting ZAF meetingstwice yearly. Central ZMSA hosted its firstannual general meeting February 13 and ishosting ZAF meetings twice a year. SouthZMSA elected a new president and isorganizing itself as a society with a first ZAFplanned for October. We continue to assistthe North ZMSA in efforts to organize; theyare at work on constitution and bylaws butno ZAF has yet been scheduled.56. In August, ZMSA presidents became thefirst point of contact from the PhysicianAdvocacy Assistance Line (PAAL). Thisservice was originally hosted by AHS, but atthe urging of the ZMSAs, AHS has agreedto transfer intake for calls coming to PAALto a third-party provider Confidence Line.ZMSA presidents will be alerted by theConfidence Line when a physician in thezone calls for help and the ZMSA presidentwill manage responding to the call.Other issuesPharmacist prescribing and scopes of practice57. AMA members continue to expressconcerns about pharmacist prescribingand increasing scopes of practice by otherhealth professions. Meetings were heldthis fall with the Alberta PharmacistsAssociation (RxA) to discuss issues ofconcern for both sides.58. Subsequently, a meeting was held with theAMA, CPSA, RxA and Alberta College ofPharmacists to discuss working together19
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Page 4 and 5: AgendaAMA Representative Forum 2012
Page 6: In MemoriamMembers deceased since t
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Page 25 and 26: 78. The AMA also nominated two addi
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Page 30 and 31: Nominating CommitteeIn accordance w
Page 32 and 33: Financial StatementsResponsibility
Page 34 and 35: Condensed Statement of Financial Po

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